Provider Demographics
NPI:1073800504
Name:VU, THANG DUC (ANP)
Entity Type:Individual
Prefix:
First Name:THANG
Middle Name:DUC
Last Name:VU
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 BLANCO CIR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4446
Mailing Address - Country:US
Mailing Address - Phone:831-755-7999
Mailing Address - Fax:831-755-7975
Practice Address - Street 1:917 BLANCO CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4446
Practice Address - Country:US
Practice Address - Phone:831-755-7999
Practice Address - Fax:831-755-7975
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20616363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health